L-arginine in the management of cardiovascular diseases

OBJECTIVE: TO examine the role of L-arginine in the management of cardiovascular diseases. DATA SOURCES: A MEDLINE search (1966-April 2000) of review articles, using the search terms arginine, nitric oxide, and cardiovascular diseases, was conducted. After reviewing these articles, primary studies using the search terms arginine, hypercholesterolemia, hypertension, diabetes, smoking, ischemic heart disease, and heart failure were reviewed. STUDY SELECTION: English-language human studies were selected and evaluated based on quality of review. DATA SYNTHESIS: Small-scale studies have demonstrated that intravenous L-arginine augments endothelial function by enhancing vasodilation and reducing monocyte adhesion. Oral supplementation demonstrated similar effects as well as improvement of exercise ability in patients with cardiovascular diseases. CONCLUSIONS: L-arginine improves the management of multiple cardiovascular diseases. However, most published human studies are small. Before therapy can be routinely recommended, larger, well-designed studies are required to confirm its effect.